Ⅱ导联RWPT标准鉴别宽QRS波的早搏

Differential diagnosis of lead Ⅱ RWPT wide QRS premature beats

目的探讨应用Ⅱ导联R波峰时间(RWPT)法对宽QRS波早搏的鉴别诊断价值。方法对已确诊的192例宽QRS波早搏患者,计算应用Ⅱ导联RWPT法对宽QRS波诊断的准确率。结果 192例宽QRS波早搏患者中,已确诊的室性早搏130例,室上性早搏伴室内差异传导62例。应用Ⅱ导联RWPT法再鉴别其激动是室性还是室上性伴室内差异传导,发现真阳性112例、假阳性8例、真阴性54例、假阴性18例;敏感度85.38%,特异度87.00%,阳性预测值93.33%,阴性预测值76.39%,准确度86.46%。结论应用Ⅱ导联RWPT法鉴别宽QRS波早搏有较高的敏感度、特异度。

Objective To investigate the differential diagnosis value of applying lead ]] R peak time （RWPT） in wide QRS Premature Ventricular Beats. Methods 192 cases of patients with a wide QRS wave premature beats have been definitive diagnosed, applying ]] lead RWPT to test the accuracy of wide QRS. Results 192 cases of patients with wide QRS Premature Ventricular Beats,130cases have been definitive diagnosed premature ventricular contractions, supra-ventricular premature beats associated with aberrant conduction 62 cases. Apply ]] lead United RWPT method to identify their excitement is Indoor difference in the ventricular or supra-ventricular conduction, the true positive 112 cases, 8 case is false positive, 54 cases is true negative, 18 cases false negatives： the sensitivity is 85.38%, is 87.00%, positive predictive value is 93.33%, negative predictive value is 76.39% and the accuracy is 86.46%. Conclusions Applying [I leads RWPT to Identify wide QRS premature comes from Premature Ventricular Beats or supra-ventricular premature beats associated with aberrant conduction have high sensitivity, specificity, positive predictive value, negative predictive value and accuracy .it has the advantage of easy and fast, and have a good clinic diagnostic value.